2022-05-16T10:36:40-05:00 2021-06-30 381357951 PLANTE & MORAN PLLC 250 S HIGH ST SUITE 100 COLUMBUS OH 43215 990 2020-07-01 310544277 MAPLE KNOLL COMMUNITIES INC MAPL 5137822400 11100 SPRINGFIELD DRIVE CINCINNATI OH 45246 JAMES STAHL CFO 5137822400 2022-05-12 1 JAMES STAHL 999009999 AMY CIMINELLO P00796388 6148493000 2022-05-12 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z SEE SCHEDULE O JAMES FORMAL 11100 SPRINGFIELD DRIVE CINCINNATI OH 45246 44956969 0 X WWW.MKCOMMUNITIES.ORG X 1934 OH MAPLE KNOLL COMMUNITIES, INC. IS A NOT-FOR-PROFIT CORPORATION WHICH PROVIDES HOUSING, HEALTH CARE AND OTHER RELATED SERVICES AND ACTIVITIES FOR THE BENEFIT OF THE ELDERLY. MAPLE KNOLL COMMUNITIES OWNS AND OPERATES TWO CONTINUING CARE RETIREMENT COMMUNITIES (CCRC) LOCATED IN CINCINNATI, OHIO AND OXFORD, OHIO. 14 14 798 380 0 0 2105161 3303819 41908883 39321141 1459689 1566560 478343 419752 45952076 44611272 611019 601879 0 0 23910565 21111666 0 0 144534 22598581 25484594 47120165 47198139 -1168089 -2586867 123427394 123123326 106604254 110186157 16823140 12937169 X MAPLE KNOLL COMMUNITIES, INC. IS RECOGNIZED AS A GROWING PROVIDER OF OUTSTANDING SENIOR COMMUNITIES AND SERVICES THAT ALLOWS THOSE WE SERVE TO THRIVE IN A STIMULATING AND DIGNIFIED ENVIRONMENT. THIS WILL BE ACCOMPLISHED THROUGH CREATIVITY AND RESPONSIBLE FISCAL STEWARDSHIP. 0 0 28137205 522727 27545395 "MAPLE KNOLL VILLAGE" - MAPLE KNOLL VILLAGE IS A NON-PROFIT CONTINUING CARE RETIREMENT COMMUNITY WITH A HISTORY OF MORE THAN 170 YEARS. LOCATED ON A BEAUTIFUL 54-ACRE CAMPUS, OUR COMMUNITY OFFERS 292 VILLAS AND APARTMENTS, 63 ASSISTED LIVING APARTMENTS AND A 145-BED NURSING FACILITY. THE COMMUNITY IS RECOGNIZED AS A TEACHING FACILITY FOR FUTURE GERIATRICIANS THROUGH THE UNIVERSITY OF CINCINNATI. THE GERIATRIC EVALUATION CENTER, A CLINICAL SERVICE OF THE UNIVERSITY FAMILY PHYSICIANS, INC. IS LOCATED ON THIS CAMPUS. 13239293 79152 11059514 "THE KNOLLS OF OXFORD" - THE KNOLLS OF OXFORD IS A NON-PROFIT CONTINUING CARE RETIREMENT COMMUNITY WITH CULTURE AND CHARM. LOCATED ON A BEAUTIFUL 85-ACRE CAMPUS, THE COMMUNITY OFFERS 108 VILLAS, 28 ASSISTED LIVING APARTMENTS AND A 62-BED SKILLED NURSING FACILITY AND REHABILITATION CENTER. THE COMMUNITY BOASTS OF A UNIQUE AFFILIATION WITH MIAMI UNIVERSITY. THIS AGREEMENT OFFERS MULTIPLE OPPORTUNITIES FOR MIAMI STUDENTS, BUT IS ALSO A TREMENDOUS BENEFIT FOR KNOLLS RESIDENTS AS WELL. 749501 0 668164 MAPLE KNOLL OUTREACH SERVICES FOR SENIORS STAFF AND VOLUNTEERS SET FORTH TO PROVIDE SERVICES TO OVER 900 OLDER ADULTS THROUGHOUT 35 COMMUNITIES THIS PAST FISCAL YEAR. MEALS ON WHEELS OFFERED THROUGH MAPLE KNOLL OUTREACH SERVICES FOR SENIORS PROVIDED MORE THAN JUST A NUTRITIOUS MEAL. THE PROGRAM ADDRESSED ISSUES RANGING FROM SENIOR ISOLATION TO A VARIETY OF NUTRITION PROGRAMS THAT HELP CLIENTS MANAGE CHRONIC HEALTH ISSUES. THE MEALS ARE DELIVERED TO THE CLIENT'S DOOR WITH THE HELP OF STAFF AND 85 TRAINED VOLUNTEERS, WHO ARE OFTEN THE ONLY PEOPLE OUR CLIENTS SEE ON A DAILY BASIS. TOGETHER THESE INDIVIDUALS DELIVERED 69,500 MEALS TO OVER 450 OLDER ADULTS. IN ADDITION, THE PROGRAM HAS ALLOWED FOR OVER 3,000 POUNDS OF DOG FOOD AS WELL AS VARIOUS CLEANING SUPPLIES TO BE DELIVERED TO HELP CARE FOR CLIENT'S FURRY FRIENDS.MOBILITY AND ACCESSIBILITY ARE ESSENTIAL FOR INDEPENDENT LIVING, AND TRANSPORTATION IS THE LINK THAT ALLOWS ACCESS TO NEEDED SERVICES AND ACTIVITIES. TRANSPORTATION PLAYS A VITAL ROLE IN THE LIVES OF OLDER ADULTS IN OUR COMMUNITY AND NO SINGLE SOLUTION CAN MEET ALL THE MOBILITY NEEDS OF THESE INDIVIDUALS RATHER, A VARIETY OF SERVICES AND SYSTEMS ARE NECESSARY TO DO SO EFFECTIVELY. MAPLE KNOLL OUTREACH SERVICES FOR SENIORS PLAYED A VITAL ROLE IN THE INDEPENDENCE OF OVER 519 OLDER ADULTS BY DRIVING OVER 60,000 MILES TO PROVIDE 9,000 TRIPS THIS PAST FISCAL YEAR. NOT STOPPING THERE, ADDITIONAL SERVICES WERE OFFERED TO HELP OLDER ADULTS STAY AFLOAT DURING THEIR TIME OF NEED. THESE INCLUDED THE OFFERING OF A HEALTHY U WORKSHOP TO BETTER SELF-MANAGE CHRONIC DISEASES FOR, FACILITATING OF HIGH SCHOOL STUDENT SOCIAL SERVICE PROJECTS TO PROVIDE LAWN BEAUTIFICATION TO IMMOBILE SENIORS AND LASTLY THE REVAMPING OF A FRIENDLY CALLER PROGRAM. THE PROGRAM NOW INCLUDES 60 PARTICIPANTS AND PROVIDES A LIFELINE TO HOMEBOUND SENIORS. THESE SERVICES ARE PROVIDING AN OPPORTUNITY FOR OLDER ADULTS TO BE ACTIVE AND SAFE, WHICH NOT ONLY ENRICHES THEIR QUALITY OF LIFE, BUT ALSO IMPROVES HEALTH AND INCREASES LONGEVITY. 407321 0 110244 MAPLE KNOLL COMMUNITIES CONTINUED TO PROVIDE AND EXPAND UPON CRUCIAL PROGRAMS BY OFFERING TWO VITAL SERVICES BASED OUT OF THE MAPLE KNOLL VILLAGE CAMPUS IN SPRINGDALE. THESE PROGRAMS, MEALS ON WHEELS AND TRANSPORTATION SERVICES, SUPPORT HOME BOUND SENIORS NEEDING EXTRA COMFORT AND ASSISTANCE. AS PROUD MEMBERS OF MEALS ON WHEELS AMERICA, MAPLE KNOLL OUTREACH SERVICE FOR SENIORS PROVIDES MUCH MORE THAN JUST MEALS AND NUTRITION EDUCATION. VOLUNTEERS GO ABOVE AND BEYOND FOR CLIENTS AND BUILD LASTING FRIENDSHIPS. CURRENTLY, THERE ARE 95 ACTIVE MEALS ON WHEELS VOLUNTEERS. STAFF AND VOLUNTEERS WORK TOGETHER AS THE ULTIMATE TEAM AS THEY RACE THROUGH NEIGHBORING COMMUNITIES DELIVERING APPROXIMATELY 90,000 MEALS TO 500 CLIENTS PER YEAR. WE ALSO DELIVERED APPROXIMATELY 1,250 POUNDS OF PET FOOD TO 40 SENIORS. OUR STAFF DROVE OVER 51,000 MILES TO PROVIDE APPROXIMATELY 8,500 MEDICAL AND NON-MEDICAL TRIPS FOR OVER 200 CLIENTS.OTHER:OTHER PROGRAMS INCLUDE WMKV 89.3 FM, A PUBLIC RADIO STATION PLAYING OLD RADIO PROGRAMS AND MUSIC FROM THE 30'S 40'S AND 50'S. WMKV HAS OVER 25,000 LISTENERS PER WEEK THROUGH ITS RADIO SIGNALS AND ONLINE STREAMING. MAPLE KNOLL COMMUNITIES MANAGES TWO HOUSING AND URBAN DEVELOPMENT HOUSING UNITS, WHICH SERVES APPROXIMATELY 94 LOW INCOME SENIORS. 407321 0 110244 42533320 1 1 0 0 0 0 0 0 0 0 1 1 0 1 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 53 0 1 798 1 1 1 0 0 0 0 1 1 0 0 0 0 0 0 X 14 14 0 0 0 0 0 1 0 1 1 0 0 1 1 1 1 1 1 0 0 1 1 X JAMES STAHL 5137822687 11100 SPRINGFIELD PIKE CINCINNATI OH 45246 JOHN C BLOOMSTROM CHAIRMAN OF THE BOARD 1.00 0.10 X X 0 0 0 FRED ROBBINS FIRST VICE-CHAIRMAN 1.00 0.10 X X 0 0 0 MARILYN HOSKINS SECOND VICE-CHAIRMAN 1.00 0.10 X X 0 0 0 KURT MARTY TREASURER 1.00 0.10 X X 0 0 0 DAVID ZUIDEMA SECRETARY 1.00 0.10 X X 0 0 0 SUSAN LANG BOARD MEMBER 1.00 0.00 X 0 0 0 PAT BENNETT BOARD MEMBER 1.00 0.00 X 0 0 0 LYNN LARSON BOARD MEMBER 1.00 0.00 X 0 0 0 JOLENE SOBOTKA BOARD MEMBER 1.00 0.00 X 0 0 0 WOODROW UIBLE BOARD MEMBER 1.00 0.00 X 0 0 0 STEVE KOMRSKA BOARD MEMBER 1.00 0.00 X 0 0 0 RICK PAYNE BOARD MEMBER 1.00 0.00 X 0 0 0 DAVID WALLACE BOARD MEMBER 1.00 0.10 X 0 0 0 TAMILYN BAKAS BOARD MEMBER 1.00 0.00 X 0 0 0 JAMES FORMAL PRESIDENT, CEO 40.00 1.00 X 435117 0 34431 JAMES STAHL CFO 40.00 1.00 X 170184 0 16422 TIMOTHY MCGOWAN VICE PRESIDENT 40.00 0.00 X 246952 0 20104 BETH THRESS VICE PRESIDENT 40.00 0.00 X 141701 0 28954 MEGAN ULRICH VICE PRESIDENT 40.00 0.00 X 127837 0 28541 ANDREW CRAIG VICE PRESIDENT 40.00 0.00 X 179948 0 30104 RENE MAROIS SPEECH THERAPIST 40.00 0.00 X 107965 0 19039 ROBERT HANNEKEN WMKV DEVELOPMENT DIRECTOR 40.00 0.00 X 118260 0 16808 CHARLES CONTI PHYSICAL THERAPIST 40.00 0.00 X 115841 0 15070 KAREN PENDLETON PHYSICAL THERAPIST 40.00 0.00 X 113169 0 18937 JOSEPH VOLKER DIRECTOR OF NURSING 40.00 0.00 X 110875 0 10611 1867849 0 239021 11 0 1 0 MORRISON COMMUNITY LIVING PO BOX 102289 ATLANTA GA 303682289 FOOD SERVICE STAFFING, FOOD, SUPPLIES, M 3329141 UPSCALE LAWN & PROPERTY MANAGEMENT PO BOX 11628 CINCINNATI OH 452111628 LAWN CARE, LANDSCAPING, SNOW REMOVAL 676104 DARWINS CONSTRUCTION LLC 559 N WAYNE AVE CINCINNATI OH 45215 CONSTRUCTION 651085 GNO CONSTRUCTION 9458 FLICK ROAD CINCINNATI OH 45247 CONSTRUCTION 645863 HGC CONSTRUCTION 2814 STANTON AVE CINCINNATI OH 45206 CONSTRUCTION 410742 16 25000 48342 2127604 1102873 5394 3303819 ROOM AND BOARD REVENUE 623000 34106744 34106744 AMORTIZED ENTRANCE FEE 623000 4393276 4393276 COMMUNITY SERVICES 623000 681410 681410 MONTESSORI PRESCHOOL 623000 102865 102865 GERIATRIC EVALUATION CENTER 623000 36846 36846 39321141 934173 934173 232915 319953 -87038 -87038 -87038 598387 34000 0 0 598387 34000 632387 632387 21200 48342 25744 -4544 -4544 WMKV UNDERWRITING 900099 160408 160408 CAFE REVENUE 900099 80843 80843 HUD MANAGEMENT FEES 900099 62176 62176 0 207907 207907 511334 44611272 39383317 0 1973161 601879 601879 1412033 1412033 15127136 14996739 10136 120261 394777 367391 27386 2539843 2436337 103506 1637877 1449294 188583 156655 156655 128400 128400 195395 195395 2887191 2646928 240263 387584 275998 111586 4898731 3942228 932230 24273 798912 130255 668657 3675014 3675014 91773 88211 3562 3471267 3424696 46571 5586997 5510997 76000 604565 604565 FOOD SERVICE 1947080 1947080 LICENSE SURCHARGE 497466 278144 219322 BAD DEBTS 137000 137000 FLORIST EXPENSE 1150 1150 19414 19414 47198139 42533320 4520285 144534 5297111 1930759 211771 49602 1564511 1286493 651350 556866 184011573 102893296 77558103 81118277 11992687 12655562 14043719 17479597 12108142 8046170 123427394 123123326 8214509 5761771 31604841 31893524 58272037 67477539 90182 74383 8422685 4978940 106604254 110186157 X 5438783 -234169 11384357 13171338 16823140 12937169 123427394 123123326 X -2586867 1080780 -2379884 X X 0 1 X 1 1 0 X 1666061 1173479 1861842 2105161 3303819 10110362 41277508 42072655 42258508 41908883 39383317 206900871 42943569 43246134 44120350 44014044 42687136 217011233 23361 25165 32982 38741 27077 147326 0 23361 25165 32982 38741 27077 147326 216863907 1103193 1413874 1434618 1199926 1167088 6318699 1103193 1413874 1434618 1199926 1167088 6318699 1245383 627525 742373 569155 470358 3654794 45292145 45287533 46297341 45783125 44324582 226984726 0.95540 0.95300 0.02780 0.02830 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2016 AMOUNT: $ 716,294. 2017 AMOUNT: $ 93,770. 2018 AMOUNT: $ 159,640. 2019 AMOUNT: $ 125,159. 2020 AMOUNT: $ 145,549. SALON REVENUE - 2016 AMOUNT: $ 156,323. 2017 AMOUNT: $ 150,229. 2018 AMOUNT: $ 143,283. 2019 AMOUNT: $ 94,408. 2020 AMOUNT: $ 35,151. CAFE REVENUE - 2016 AMOUNT: $ 244,792. 2017 AMOUNT: $ 255,916. 2018 AMOUNT: $ 268,546. 2019 AMOUNT: $ 224,489. 2020 AMOUNT: $ 80,843. TELEPHONE/INTERNET/CABLE REVENUE - 2016 AMOUNT: $ 5,308. 2017 AMOUNT: $ 6,179. 2018 AMOUNT: $ 5,268. 2019 AMOUNT: $ 5,887. 2020 AMOUNT: $ 5,604. FUNDRAISING REVENUE - 2016 AMOUNT: $ 12,000. 2017 AMOUNT: $ 15,500. 2018 AMOUNT: $ 20,475. 2019 AMOUNT: $ 20,310. 2020 AMOUNT: $ 21,200. CATERING REVENUE - 2016 AMOUNT: $ 110,666. 2017 AMOUNT: $ 105,931. 2018 AMOUNT: $ 128,561. 2019 AMOUNT: $ 83,818. 2020 AMOUNT: $ 13,874. MKC SERVICE CENTER REVENUE - 2018 AMOUNT: $ 16,600. 2019 AMOUNT: $ 15,084. 2020 AMOUNT: $ 7,729. WMKV UNDERWRITING - 2020 AMOUNT: $ 160,408. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1960425 1960425 147946114 76738451 71207663 13554224 9516100 4038124 20211649 16638745 3572904 339161 339161 81118277 DEBT SERVICE FUNDS 2875829 F BENEFICIAL INTEREST IN IRREVOCABLE TRUST 12101257 F INTEREST SERVICE FUND 2502511 F 17479597 OTHER NONCURRENT ASSETS 8046170 8046170 PROVISIONS FOR INTEREST RATE SWAP 1111831 CAPITAL LEASES PAYABLE 58107 PPP LOAN 3604530 OPERATING LEASE PAYABLE 204472 4978940 X 40414648 1080780 -5293541 -4212761 44627409 -16137 -16137 44611272 46776087 345697 345697 46430390 767749 767749 47198139 PART X, LINE 2: NO PROVISION FOR INCOME TAXES HAS BEEN INCLUDED IN THE FINANCIAL STATEMENTS SINCE THE ORGANIZATION IS EXEMPT FROM SUCH TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, ALL YEARS SINCE INCEPTION COULD BE SUBJECT TO REVIEW BY THE IRS. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE ORGANIZATION AND HAS CONCLUDED THAT, AS OF JUNE 30, 2021, THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 140,793. NONOPERATING EXPENSES INCLUDED IN REVENUE ON FS -19,414. GRANTS TO INDIVIDUALS -601,878. CHANGE IN FAIR VALUE OF INTEREST RATE SWAP -4,813,042. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES REPORTED ON PART VIII -319,953. FUNDRAISING EXPENSES REPORTED ON PART VIII -25,744. CAPITAL CONTRIBUTION REPORTED ON PART VIII 183,103. INVESTMENT MANAGEMENT FEES 146,457. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES REPORTED ON PART VIII 319,953. FUNDRAISING EXPENSES REPORTED ON PART VIII 25,744. PART XII, LINE 4B - OTHER ADJUSTMENTS: NONOPERATING EXPENSES INCLUDED IN REVENUE ON FS 19,414. GRANTS TO INDIVIDUALS 601,878. INVESTMENT MANAGEMENT FEES 146,457. WMKV GOLF OUTING 69542 48342 21200 24373 1371 69542 48342 21200 24373 1371 25744 -4544 1 0 0 CHARITABLE ASSISTANCE - RENT 16 601879 N/A N/A PART I, LINE 2: RESIDENTS MUST MEET SET FINANCIAL CRITERIA TO QUALIFY FOR ASSISTANCE. CFO REVIEWS FINANCIAL INFORMATION WITH RESIDENT AND DETERMINES HOW MUCH THE RESIDENT CAN AFFORD TO PAY FOR RENT. ACTUAL RENT IS THEN REDUCED WITH THE ASSISTANCE BY THE DETERMINED AMOUNT. X 1 1 X X X 0 1 0 0 0 0 0 1 0 JAMES FORMAL PRESIDENT, CEO 292000 0 50000 0 93117 0 8400 0 26031 0 469548 0 0 0 TIMOTHY MCGOWAN VICE PRESIDENT 181455 0 45000 0 20497 0 6984 0 13120 0 267056 0 0 0 ANDREW CRAIG VICE PRESIDENT 145111 0 30000 0 4837 0 5097 0 25007 0 210052 0 0 0 JAMES STAHL CFO 124591 0 10000 0 35593 0 4738 0 11684 0 186606 0 0 0 BETH THRESS VICE PRESIDENT 97872 0 30000 0 13829 0 3947 0 25007 0 170655 0 0 0 MEGAN ULRICH VICE PRESIDENT 97566 0 20000 0 10271 0 3534 0 25007 0 156378 0 0 0 PART I, LINE 1A CEO USES FOR BUSINESS PURPOSES. THE COST IS NOT INCLUDED IN THE CEO'S TAXABLE INCOME. PART I, LINE 4B THE ORGANIZATION MADE CONTRIBUTIONS TO A NONQUALIFIED RETIREMENT PLAN FOR THE FOLLOWING INDIVIDUALS: JAMES FORMAL $23,000 MAPLE KNOLL COMMUNITIES ADOPTED THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN FOR THE EXECUTIVE REFERENCED ABOVE IN 2007. A PORTION OF THE COMPENSATION HAS BEEN DEFERRED IN ACCORDANCE WITH TERMS OF THE AGREEMENT WHICH STATES THAT THE EXECUTIVE WILL BE ENTITLED TO RECEIVE THIS BENEFIT UPON RETIREMENT. IN 2019 THIS SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN WAS AMENDED TO DISTRIBUTE THE VESTED PORTION OF THE RETIREMENT PLAN ASSETS IN OCTOBER 2019 AND OCTOBER 2022 TO THE EXECUTIVE. THE AMOUNTS LISTED ABOVE ARE INCLUDED IN COMPENSATION REPORTED IN SCHEDULE J, PART II, COLUMN C. PART I, LINE 7 PER FORMAL'S EMPLOYMENT CONTRACT, EMPLOYEE SHALL BE ELIGIBLE TO RECEIVE A PERFORMANCE BONUS. THE BOARD, OR THE BOARD'S DESIGNEE, SHALL EVALUATE EMPLOYEE'S PERFORMANCE AND HIS ACHIEVEMENT OF THE GOALS AND OBJECTIVES ESTABLISHED BY THE BOARD FOR SUCH FISCAL YEAR, INCLUDING ACTIONS TO BE TAKEN TO IMPLEMENT MAPLE KNOLL'S LONG-TERM BUSINESS STRATEGY, AND SHALL RECOMMEND THE AMOUNT, IF ANY, OF EMPLOYEE'S PERFORMANCE BONUS, WHICH RECOMMENDATION WILL BE SUBJECT TO THE BOARD'S APPROVAL. WHILE IT IS AGREED THAT THE PAYMENT OF A PERFORMANCE BONUS IS AT THE DISCRETION OF THE BOARD, IT IS ANTICIPATED THAT ANY BONUS PAID WILL BE AN AMOUNT EQUAL TO FROM ZERO (0) TO TWENTY-FIVE PERCENT (25%) OF THE EMPLOYEE'S BASE SALARY DEPENDING UPON EMPLOYEE'S PERFORMANCE AND HIS ACHIEVEMENT OF THE GOALS AND OBJECTIVES ESTABLISHED BY THE BOARD FOR THE IMMEDIATELY PRECEDING FISCAL YEAR. THE FOREGOING RANGE IS INTENDED TO BE A GUIDELINE ONLY. FIFTEEN PERCENT (15%) WILL BE THE ANNUAL TARGET BUT THE BONUS MAY EXCEED 25% PERCENT OF THE EMPLOYEE'S BASE SALARY IF, IN ITS DISCRETION, THE BOARD DETERMINES SUCH LARGER AMOUNT IS WARRANTED. A BUTLER COUNTY PORT AUTHORITY 651235109 12355RAT3 2021-05-27 35215000 SEE PART VI 0 0 0 A 35215009 2479564 704300 29528634 2502511 1 1 0 1 A 0 0 0 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 PART I, LINE A, COLUMN (F): CURRENTLY REFUND THE ORGANIZATION'S TAX-EXEMPT 2013B BONDS AND 2013C BONDS; PAY ACCRUED INTEREST ON THE TAX-EXEMPT BONDS BEING CURRENTLY REFUNDED; RETIRE CERTAIN OUTSTANDING TAXABLE OBLIGATIONS; PAY COSTS OF ACQUIRING, CONSTRUCTING, INSTALLING AND EQUIPPING CAPITAL IMPROVEMENTS AT THE CONTINUING CARE RETIREMENT COMMUNITIES OWNED AND OPERATED BY THE ORGANIZATION; DEPOSIT FUNDS INTO A DEBT SERVICE RESERVE FUND; AND PAY COSTS OF ISSUANCE ON THE BONDS. PART II, LINE 3: TOTAL PROCEEDS OF ISSUE AS OF 6/30/2021 ARE SALE PROCEEDS PLUS INVESTMENT PROCEEDS EARNED ON THE DEBT SERVICE RESERVE FUND. FORM 990, SECTION C, DOING BUSINESS AS NAME: MAPLE KNOLL VILLAGE, THE KNOLLS OF OXFORD, MAPLE KNOLL OUTREACH SERVICES FOR SENIORS, WMKV-FM, VILLAGE HOME AND HOSPICE FORM 990, PART VI, SECTION A, LINE 7A RESIDENTS ELECT ONE BOARD MEMBER. FORM 990, PART VI, SECTION B, LINE 11B A COPY OF THE 990 IS UPLOADED TO BOARDPAQ, AN ONLINE BOARD MANAGEMENT SOFTWARE PACKAGE THAT ALLOWS THE BOARD MEMBERS TO REVIEW THE 990, PRIOR TO THE FILING DATE FORM 990, PART VI, SECTION B, LINE 12C A CONFLICT OF INTEREST POLICY IS COMPLETED ONCE A YEAR AT A BOARD MEETING BY THE BOARD OF DIRECTORS. THE POLICY ALSO COVERS KEY MEMBERS OF THE ORGANIZATION. THE BOARD DETERMINES IF A POTENTIAL CONFLICT EXISTS, REVIEWS THE FACTS AND CIRCUMSTANCES, AND VOTES ON THE FINAL DETERMINATION, EXCLUDING THE MEMBER WHO HAS THE POTENTIAL CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 FOR THE CEO, THE COMPENSATION COMMITTEE MEETS ANNUALLY TO REVIEW THE CURRENT SALARIED COMPENSATION AND BONUS PACKAGE, BASED ON THE CONTRACTUAL AGREEMENT SIGNED IN THE CEO'S SALARY CONTRACT. THE ORANIZATION PARTICIPATES IN THE CHIEF EXECUTIVE FOR MULTI-SITE ORGANIZATIONS SURVEY SPONSORED BY LEADING AGE. THE RESULTS OF THIS SURVEY ARE SHARED WITH THE COMPENSATION COMMITTEE WHO THEN DETERMINES THE COMPENSATION AND EMPLOYMENT CONTRACT OF THE CEO. COMPENSATION FOR OFFICERS AND OTHER KEY EMPLOYEES IS REVIEWED BY THEIR SUPERIOR OFFICER DURING THEIR ANNUAL PERFORMANCE APPRAISAL TO DETERMINE COMPENSATION AMOUNTS. ALL SUPERIOR OFFICERS ARE INDEPENDENT OF THE OFFICERS AND KEY EMPLOYEES THAT HE OR SHE IS REVIEWING. THIS POLICY WAS LAST REVIEWED IN 2021. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST. FORM 990, PART XI, LINE 9: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 140,793. LOSS ON BENEFICIAL INTEREST 2,292,365. LOSS ON ADVANCE REFUNDING OF DEBT -4,813,042. FORM 990, PART XII, LINE 2C: THE BOARD OF DIRECTORS OVERSEES THE AUDIT PROCESS AND APPROVES THE INDEPENDENT AUDIT FIRM. THIS PROCESS HAS NOT CHANGED FROM PRIOR YEARS. FORM 990, PART XII, LINE 3B: THE REQUIRED SINGLE AUDIT AS SET FORTH IN THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133 HAS NOT YET BEEN COMPLETED. PLANS HAVE BEEN MADE TO HAVE THE REQUIRED SINGLE AUDIT COMPLETED BY THE EXTENDED DUE DATE AS ESTABLISHED IN OMB M-20-26. MAPLE KNOLL PROFESSIONAL BUILDING LLC 11100 SPRINGFIELD PIKE CINCINNATI OH 45246 RENTAL OFFICES OH 231652 2031052 MAPLE KNOLL COMMUNITIES SYCAMORE-ANDERSON SENIOR HOUSING INC 11100 SPRINGFIELD PIKE CINCINNATI OH 45246 311209103 HUD SUBSIDIZED HOUSING OH 501(C)(3) 509(A)(2) MAPLE KNOLL COMMUNITIES INC 1 SYCAMORE-ANDERSON SENIOR HOUSING II INC 11100 SPRINGFIELD PIKE CINCINNATI OH 45246 311428462 HUD SUBSIDIZED HOUSING OH 501(C)(3) 509(A)(2) MAPLE KNOLL COMMUNITIES INC 1 MKVINC 11100 SPRINGFIELD PIKE CINCINNATI OH 45246 310914017 HUD SUBSIDIZED HOUSING OH 501(C)(3) 509(A)(2) MAPLE KNOLL COMMUNITIES INC 1 0 1 0 0 0 0 0 0 0 0 0 1 0 0 1 0 1 1 0